Project Summary Abstract The Pilot Project Program is an important component of NAMDC, and supports 1-2 pilot projects annually. NAMDC pilot projects focus on biomarkers, diagnosis, natural history, and treatment of mitochondrial diseases. Thus, projects must be human subject studies, including: patients, human cells, tissues, or body fluid samples. Pilot grants are often a first step for junior investigators, where the grant application is often a first formal application. The Pilot Core provides multiple mentoring steps for junior investigators including feedback: on initial proposals (including unfunded proposals to improve the quality of the application), along the full grant development process, and during project implementation. Mentoring is done by the NAMDC PI, Statistical PI, Pilot Core PI, local site PI, NAMDC Clinical Liaison, and additional resources as needed. The NAMDC Pilot/New Program Committee is responsible for reviewing the pilot/new project proposals. Applicants for Pilot Projects must be NAMDC members. The NAMDC Pilot Project Committee recommends funding decisions that best meets the needs and priorities of the consortium and encourages its growth. Selection for funding is based upon information from written peer review and from the NAMDC PIs following oral presentation at the annual Face-to- Face meeting. Following the recommendation by the Pilot Program Committee, the NAMDC Executive Committee makes the ultimate decision as to what pilot/new projects will be funded with input from the RDCRN and approval from the NIH officers. Multicenter studies will be prioritized over a single-site study projects. Applicants apply for funding for projects that occur during the 12-month window of NAMDC yearly cycle of NIH funding. This means that applicants apply for projects that will be carried out between September 1st through August 31 of the following year. Grantees are expected to submit a brief quarterly report, a preliminary report presentation at the annual Face-to-Face meeting, and a final report within two months of the conclusion of the grant.